Background: Meditation is a mind and body practice for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being. Many studies have already been carried out to see the effect of Yoga, Pranayam, meditation, Sudarhan Kriya on physiological parameters, but till date, there is not a single study which shows the cumulative effect of yoga, pranayam, meditation along with sudarshankriya on physiological parameters.Methods: This observational study was conducted in the Department of Physiology, Rajasthan University of Health Sciences, Jaipur and in association with Art of living organization. The study participants were enrolled into three groups. In the first group, 10 participants of Advance Meditation Program (AMP), who were doing this program for the first time, in second group, 10 participants who were doing AMP along with regularly practicing Padam Sadhna for at least 2 years and finally, in the third group, 10 participants who were not practicing any kind of meditation or yoga. After consent, subjects filled the Cohen's stress questionnaire. Electrocardiography (ECG) was recorded before AMP and after AMP.Results: There was significant difference in heart rate (P = 0.002), systolic blood pressure (P = 0.028), diastolic blood pressure (P = 0.005), RR interval (P = 0.020), PR interval (P = 0.040), and stress score (P = 0.027) in first time participants. Similarly, in the second group (repeaters) also significant difference was noticed.Conclusion: AMP has its positive effects on ECG, blood pressure, and stress level. Thus, it can be considered as one of the important nonpharmacological methods for prevention of stress, anxiety, and cardiovascular diseases.

India is a country of enlightened Yogis and spiritual culture. Spiritual practices such as Yoga and Asana had always been an integral part of ancient Indian culture. Definition of health itself has a component of spiritual well-being.[1] Different methods of meditation are popular worldwide, i.e., transcendental meditation, Sahaj Yoga, Tibetan Buddhist meditation, etc. Meditation is a state of consciousness, characterized by marked cortical changes that are different from those in ordinary wakefulness, relaxation at rest, and sleep.[2] Yoga is a psycho-somatic-spiritual discipline for achieving union and harmony between our mind, body, and soul and the ultimate union of our individual consciousness with the Universal Consciousness.[3] One of few mechanisms contributing to a state of calm alertness includes the increased parasympathetic drive.[4] By voluntarily controlling breathing patterns, it is possible to influence autonomic nervous system functions, including heart rate (HR) variability, cardiac vagal tone,[5],[6],[7] and chemoreflex sensitivity.[8]

The Art of Living Advance Meditation Program (AMP), is a residential program for a minimum of 3 days in silence, provides optimal conditions for going deep within. The practice of silence – of consciously withdrawing our energy and attention from outer distractions – has been used in different traditions throughout time as a pathway to physical, mental, and spiritual renewal. The AMP includes; rejuvenating yoga (Padam Sadhna), breathing technique-Sudarshan Kriya Yoga (SKY) and Pranayam, 3 days of guided silence practice and unique-guided meditations designed by H. H. Sri Sri Ravi Shankar, founder of Art of Living organization. The course is typically held as a residential retreat in a place of natural beauty and tranquillity.

SKY is a rhythmic breathing technique consisting of the five stages, i.e., Ujjayi, Bhastrika, Om, Sudarshan Kkriya, and Yoga Nindra.[9],[10] Ujjayi is a Sanskrit word means victory. Ujjayi is a pattern of breath which is a part of pranayam. Bhastrika is also a variant of pranayam which contains forceful inhalation and exhalation with full vital capacity. Sudarshan is a Sanskrit word which literally means “proper vision by purifying action.” SKY is a practice of wellness[11] which reduces stress, produces relaxation, and increases sensitivity in sensory transmission, leading to an increase in attention and vigilance.[10],[11] Padam Sadhna is a sequence of Asanas (Physical postures) with ujjayi breath.

In the art of living AMP-yoga, pranayam, meditation and Sudarshan Kriya are taught simultaneously to the participants and participants have to practice all; along with 3 days of guided silence. Hence, we conducted this study to evaluate the cumulative effect of yoga, pranayam, meditation and Sudarshan Kriya on physiological parameters. It is the world's first study from the best of our knowledge which shows the effect of yoga, pranayam, meditation, sudarshankriya, and silence on physiological parameter, i.e., systolic blood pressure (SBP), diastolic blood pressure (DBP), and electrocardiography (ECG).

Methods

This observational descriptive study was conducted in the Department of Physiology, Rajasthan University of Health Sciences, Jaipur and in association with Art of living organization. Study participants were divided into three groups. In the first group, 10 participants of AMP, who were doing this program for the first time, in the second group 10 participants who were also doing AMP and regularly practicing Padam Sadhna for at least 2 years and finally, in the third group, 10 participants who were not practicing any kind of meditation or yoga.

Inclusion criteria

Age 18–40 years

Pure vegetarian

Those who gave consent.

Exclusion criteria

Medication for any chronic illness

Smokers and alcoholics

Any drug addiction.

For stress score, we used Cohen's scale.

After consent, subjects filled the Cohen's stress questionnaire. Anthropometric parameters and detailed general physical examination were done. ECG was recorded by AD digital physiograph in Physiology research laboratory before AMP and after AMP and then compared the results.

Data thus collected were entered into Microsoft Excel software, and all statistical analysis was performed using IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp. Mean and standard deviations were calculated. For continuous data, Student's paired t-test and unpaired t-tests and for ordinal data Wilcoxon Rank Sum and Mann–Whitney Rank Sum tests were applied. The value of P < 0.05 was considered as statistically significant.

Results

Study participants of all the three groups were young healthy adults having mean age of 26.1 ± 4.2, 27.1 ± 4.2, and 25.1 ± 4.4 [Table 1].

After AMP, statistically significant decrease in SBP was observed both in Group 1 (122.5 ± 6.267–118.2 ± 3.027, P = 0.028) [Table 2] and Group 2 (123.7 ± 5.854–116.7 ± 4.321, P = 0.002) [Table 3]. In Group 3, decrease in SBP was not statistically significant (P = 0.634) [Table 4] and [Graph 2]. After intervention, there was significant difference in SBP in Group 1–3 (P = 0.037) and Group 2–3 (P = 0.048). The difference in SBP in Group 1 and 2 was not significant (P = 0.409) [Table 5] as Group 2 is already practicing Sudharshankriya for at least 2 years so their HR is already decreased and SBP of Group 1 decreased after AMP.

Diastolic blood pressure

DBP was significantly decreased after AMP in Group 1 (84.86 ± 3.976–80.29 ± 3.546, P = 0.005) [Table 2] and Group 2 (81.83 ± 4.021–78.67 ± 2.066, P = 0.042) [Table 3]. No significant difference was found in Group 3 (P = 0.208) [Table 4] and [Graph 3]. After AMP significant difference was observed in Group 2 and 3 (P = 0.036). The difference in DBP in Group 1–2 and 1–3 was not statistically significant [Table 5].

RR interval

While recording ECG, RR interval was significantly increased after AMP in Group 1 (0.66 ± 0.049–0.73 ± 0.047, P = 0.020) [Table 2] and Group 2 (0.71 ± 0.074–0.80 ± 0.061, P = 0.045) [Table 3]. In Group 3, there was no significant change in RR interval before (0.69 ± 0.119) and after (0.69 ± 0.106) AMP (P = 0.799) [Table 4] and [Graph 4]. After intervention, there was a significant difference in mean RR interval between 2 and Group 1 (P = 0.038). No significant difference was observed in Group 1–3 (P = 0.402) and 2–3 (0.059) [Table 5].

PR interval

Group 1 (0.13 ± 0.015–0.14 ± 0.025, P = 0.040) [Table 2] and Group 2 (0.12 ± 0.023–0.15 ± 0.024, P = 0.047) [Table 3] showed significant increase in PR interval after AMP. In Group 3, there was no significant difference in PR interval before and after AMP (P = 0.997) [Table 4] and [Graph 5]. After doing AMP significant change was not seen in PR interval in Group 1 and 2 (P = 0.505) as both the groups are the art of living followers, and Group 2 is already doing SudharshanKriya for at least 2 years. However, significant difference was observed in Group 1–3 (P = 0.036) and Group 2–3 (P = 0.009) as Group 1 and 2 participated in AMP and there PR interval raised after AMP while there was no significant change in Group 3 [Table 5].

Other electrocardiography parameters

There were no significant changes in other ECG parameters, i.e., QRS interval, QT interval, JT interval, T peak tend interval, QTc and P duration in pre- and post-AMP in all the three groups [Table 2], [Table 3], [Table 4]. There was a significant change in QT interval in Group 2–3 after AMP (P = 0.037) [Table 5].

Stress score

Mean stress score was significantly decreased after AMP in both Group 1 (19.43 ± 3.910–11.71 ± 6.651, P = 0.027) and Group 2 (13.33 ± 4.320–9.33 ± 3.932, P = 0.046), whereas stress score of Group 3 was increased although that increase was not significant (P = 0.416) [Table 2], [Table 3], [Table 4] and [Graph 6]. There was a significant difference in baseline stress score in art of living teachers group and first time meditating group (P = 0.026) as art of living teachers group was regularly practicing SudarshanKriya for two or more years, and hence, their stress scores were already low as compared to first time meditators. After AMP significant difference in stress score was not found in Group 1 and 2 (P = 0.387) as stress score of Group 1 was already low and after doing AMP stress score of Group 2 was also decreased so significant difference was not observed after AMP. There was a significant difference in stress level in Group 1–3 (P = 0.040) and Group 2–3 (P = 0.005) after AMP as after doing AMP stress level of Group 1 and 2 decreased and there was no significant change in Group 3 as this group was not doing AMP [Table 5].

Discussion

The study showed a significant decrease in HR in Group 1 and Group 2 after doing AMP similar to the study of Somwanshi et al.[12] in Latur, Maharastra where statistically significant (81.07 ± 4.8–73.93 ± 4.77, P < 0.0001) decrease in HR was found after 12 weeks of practice of SKY. Parmar et al.,[13] Barnes et al.,[14] Devasena and Narhare,[15] Ahmad et al.,[16] and Bharshankar et al.[17] also found similar results.[13]

A significant decrease in DBP was seen in our study in Group 1 and Group 2. Somwanshi et al.[12] studied on the effect of SKY on cardiorespiratory parameters and found that SKY showed statistically significant (81.07 ± 4.25–75 ± 4.25, P < 0.0001) decrease in DBP after 12 weeks of practice. Similar results were also observed by Devasena and Narhare,[15] Ahmad et al.,[16] Parmar et al.,[13] Bharshankar et al.,[17] and Gandhi and Kumar.[19] Kalwale and Shete[20] observed a significant decrease in SBP after 1 month of pranayama training, but no change in DBP. The decreased blood pressure might be associated with increased vagal tone and reduced sympathetic activity.[21]

Kharya et al.[22] studied on effect of controlled breathing exercises on the psychological status and the cardiac autonomic tone: Sudarshan Kriya and Prana-Yoga in young healthy volunteers in Dehli and found that significant improvement in stress management skills (56.7 ± 7.7–66.7 ± 6.8, P = 0.01) was also observed in SK group similar to our study where stress scores showed significant decrease after AMP in both groups.

The study showed a significant increase in R-R interval (RRI) after doing AMP in Group 1 and 2. Similar increase in mean RRI after Sahaja Yoga Meditation was observed in study of Rai et al.[23] (0.7070 ± 0.707–0.7080 ± 7.675), but this increase was not statistically significant (P = 0.910). Kharya et al.[22] also observed nonsignificant increase in the mean RRI within the group and in between the group after sudarshankriya. This may be because that we have observed the effect of AMP which includes various meditations and Padam Sadhna also along with Sudarshan Kriya while Kharya et al. studied only on Sudharshan Kriya effects.

Conclusion

AMP has its positive effects on ECG, blood pressure and stress level. It can be considered as an adjunct of the medical management as well as nonpharmacological method for prevention of stress, anxiety, and cardiovascular diseases. These practices should be incorporated in the present education system for primordial prevention of these diseases and promotion of health.

Acknowledgment

The study was conducted with the help of art of living volunteers from the art of living ashram Jaipur (Rajasthan).

Deepak KK. The Role of Autonomic Nervous System in Rapid Breathing Practices. Proceedings: Science of Breath. International Symposium on Sudarshan Kriya, Pranayam and Consciousness, New Delhi, All India Institute of Medical Sciences; 2002. p. 43-6.